Fruit juice targeted in war on obesity

Experts sound warnings about varied offerings and health problems

In recent years, many school districts have ditched soda in favor of 100 percent juice. But health experts increasingly agree it¿s not a better alternative.
(Jose M. Osorio, Chicago Tribune / May 24, 2012)

Over the past decade, the nation's war on obesity has targeted some fairly obvious culprits, including fast food, pastries, fried foods and soda.

But recent scientific studies and a new government-sponsored documentary that aired last week on HBO have identified a new, less obvious enemy: fruit juice.

This might surprise the many parents and school districts that in recent years have proudly ditched soda in favor of 100 percent juice. But health experts increasingly agree that it is not a better alternative.

"Juice is just like soda, and I'm saying it right here on camera," pediatric obesity specialist Robert Lustig said in the documentary "The Weight of the Nation," produced in conjunction with the Centers for Disease Control and Prevention. "There is no difference. When you take fruit and squeeze it, you throw the fiber in the garbage. That was the good part of the fruit. The juice is nature's way of getting you to eat your fiber."

The American Academy of Pediatrics has advised limiting daily juice consumption to 4 to 6 ounces for children 6 and younger and 8 to 12 ounces (the size of a soda can) for children 7 to 18. The academy's head of environmental health, Jerome Paulson, took it even further when he told the Tribune in December that children do not need to drink any juice at all.

"Don't drink an apple," he said. "Eat an apple."

An important difference between fruit juice and fruit, researchers point out, is that calories and sugar delivered in liquid form don't trigger feelings of fullness and can lead to excess consumption.

Beverage-makers dispute claims that fruit juice and obesity are linked. The Juice Products Association said it supports the pediatrics group's recommendations on juice but added that "current scientific evidence does not support a relationship between being overweight and juice consumption."

As proof, the association cited a cross-sectional study — a snapshot in time — funded by the juice industry that found a correlation between consumption of 100 percent fruit juice and higher nutrient intake in children.

In response, University of North Carolina global nutrition professor Barry Popkin cited six other studies that show correlations between increased fruit juice consumption and increased risk of obesity and diabetes.

"There are no studies that show the opposite — that drinking a glass or two of fruit juice each day will have positive long-term health benefits on weight or diabetes," added Popkin, author of "The World Is Fat: The Fads, Trends, Policies, and Products That Are Fattening the Human Race."

In recent months, so-called sugar-sweetened beverages (often sweetened not with sugar, but with high-fructose corn syrup) have come under increasing attack for their contribution to the obesity epidemic. Whether this label should be applied to fruit juice is subject to debate, with some organizations counting only those juices with sugar added.

But even 100 percent juice beverages can contain as much sugar as there is in soda. In addition, most commercial fruit juice is derived from concentrates, which often results in a higher sugar content than if the product were, say, simply squeezed from oranges.

CurrentU.S. Department of Agricultureguidelines suggest eating about 2 cups of fruit a day, with the majority consisting of whole fruit rather than juice. That would cap consumption for even the most active adults and children to 1 cup, or 8 ounces, of juice a day.

In schools, guidelines allow juice to be substituted for fruit in no more than half the planned meals "because it lacks dietary fiber and when consumed in excess can contribute extra calories," according to the USDA.

With holdings that include Minute Maid and Odwalla,Coca-Colaranks as the No. 1 fruit juice-maker in the world and is a member of the Juice Products Association. Rhona Applebaum, vice president and chief scientific and regulatory officer for the company, said she is aware of the pediatric academy's recommendation on fruit juice but might still give her son triple that amount.

"I respect what they have to say," Applebaum said. "But as a mom, if my 16-year-old can handle the calories and wants a nutritious beverage, I don't think there's anything wrong with him having a glass of orange juice in the morning and then later with his lunch and dinner. But I want to make sure it's calcium-fortified, because I want him to build strong bones."

Applebaum said she saw most of "The Weight of the Nation" and is generally pleased with its messages on diet and exercise. But she said equating juice with soda is an "over-exaggeration."

Although juice delivers calories and sugar on par with soda, she said, "orange juice also provides your recommended daily allowance of vitamin C and folic acid and more potassium than a banana. It's all about the how, how much and how often."

Chicago-based Tropicana, owned byPepsiCo Inc., produces the best-selling orange juice in the U.S. and contends that it is working hard to provide healthier options. One such product is Trop50, a less-sweet drink that contains a day's supply of vitamin C in a 50-calorie, 8-ounce serving.

"While USDA recommends a majority of fruit servings come from whole fruit, the fact is most Americans are falling short," a Tropicana spokeswoman said in a statement. She further noted that USDA guidelines allow for as much as 8 ounces of juice a day "because it can play a role in helping people meet their daily goals and get vital nutrients."

While the public health community is coming to increasing agreement on fruit juice, some believe it could take years to persuade parents and school districts to act on the findings.

Dr. Elsie Taveras, a pediatrician who serves as co-director of the Obesity Prevention Program at Harvard Medical School, said the message on juice has come as a surprise to her patients.

"It's not so difficult to convince a family that soda really has no nutritional benefits," Taveras said in the documentary. "It's harder to convince families that juice can have almost exactly the same sugar content as a glass of soda."

Popkin admits that he couldn't have imagined warning people off fruit juice 10 years ago.

"But it has taken us about a decade to truly understand the role of fruit juice," he said in an email. "In many countries, soft drink companies have fought hard to replace soft drinks with fruit juice (made by juice companies they bought), but the research has shown fruit juice has the same effect as soft drinks on our health — all adverse, negative and fairly severe."